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General NPI Number Information
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NPI Number | 1093651689
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Entity Type | Organization
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Legal Business Name | YM SNF OPS LLC
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Dates
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Enumeration Date | 04/27/2026
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Last Update Date | 04/27/2026
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Provider Practice Location Address
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Address Line | 500 S YORK ST
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City | MUSKOGEE
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State | OK
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Zip | 74403-5956
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Country | US
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Telephone | 918-682-6724
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Fax |
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Provider Business Mailing Address
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Address Line | 1305 SE ADAMS ST
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City | IDABEL
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State | OK
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Zip | 74745-5240
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Country | US
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Telephone | 580-286-1065
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Fax | 580-286-3926
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Authorized Official
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Title or Position | REGIONAL DIRECTOR
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Name | KATHY SUZETTE BAUCOM
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Credential |
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Telephone | 479-312-8280
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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